Individual
INGRID DUDLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3058 HIGHWAY 162, CAMPBELLTON, FL 32426-7236
(850) 628-8387
Mailing address
3058 HIGHWAY 162, CAMPBELLTON, FL 32426-7236
(850) 628-8387
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104411500
—
FL
Enumeration date
05/19/2021
Last updated
05/19/2021
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